| NPI | 1497455521 |
|---|---|
| Former Name | KIMBERLY DIANE ROGERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 18490) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 63689) |
| Enumeration Date | 2023-03-07 |
| Last Update Date | 2023-03-07 |